Asthma in Children (cont.)

Syed Shahzad Mustafa, MD

After growing up in the Rochester area, Dr. Mustafa pursued his undergraduate studies at the Johns Hopkins University in Baltimore and attended medical school at SUNY Buffalo. He then completed his internal medicine training at the University of Colorado and stayed in Denver to complete his fellowship training in allergy and clinical immunology at the University of Colorado, National Jewish Health, and Children's Hospital of Denver.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What is the prognosis for asthma in children?

The prognosis is best in young children who wheeze with viral respiratory infections and who have no symptoms in between these episodes. It can often be difficult to differentiate these “early wheezers” from children with true asthma. Children with recurrent symptoms tend to have ongoing asthma later in life. Boys “outgrow” asthma more often than girls, and a child with no evidence of environmental allergies has a better chance of “outgrowing” asthma as compared to a child with concurrent allergic disease (hay fever). Even in children with ongoing asthma, prognosis is excellent for those with preserved activity level and lung function through the use of appropriate medications.

Can asthma in children be prevented?

With the increasing prevalence of asthma, numerous studies have looked at risk factors and ways to potentially prevent asthma. It has been shown that children living on farms are protected against wheezing, asthma, and even environmental allergies. The role of air pollution has been questioned in both the increased incidence of asthma and in regards to asthma exacerbations. Climate change is also being studied as a factor in the increased incidence of asthma. Maternal smoking during pregnancy is a risk factor for asthma and poor outcomes. Secondhand tobacco smoke is also a significant risk factor for development and progression of asthma. Up to 50% of children who experience significant respiratory syncytial virus (RSV) infection are eventually diagnosed with asthma. Evidence suggests that the risk of asthma is reduced in children with a history of certain infections, rural living, exposure to other children (including older siblings), and less frequent use of antibiotics. The development of asthma is ultimately a complicated process influenced by many environmental and genetic factors, and therefore there is no proven way to decrease a child's risk of developing asthma.